Gluretor 0.5mg Tablet 1 Strip

✔️ Indications: Gluretor 0.5

Gluretor is prescribed as an adjunct to diet and exercise for lowering blood glucose levels in patients with Type 2 diabetes mellitus (NIDDM) when dietary and lifestyle modifications alone fail to achieve adequate glycemic control.

• It is also indicated for combination therapy with Metformin in cases where either Gluretor or Metformin alone is insufficient to control blood glucose levels.

Note: This medication should only be taken under the guidance of a registered physician.

✔️ Mechanism of Action: Gluretor 0.5

• Gluretor (Repaglinide) binds to specific receptors on pancreatic beta cells, leading to the closure of ATP-dependent potassium (K+) channels.
• This causes depolarization of the cell membrane, allowing calcium (Ca++) influx into the cells.
• The increased intracellular calcium triggers insulin secretion, thereby reducing blood glucose levels.

✔️ Side Effects of Gluretor 0.5

• Common side effects:
  • Hypoglycemia (low blood sugar), with symptoms like dizziness, sweating, confusion, and weakness.
  • Gastrointestinal issues, including diarrhea, constipation, nausea, and vomiting.
  • Upper respiratory tract infections.
• Rare hypersensitivity reactions:
  • Skin rashes, urticaria (hives).

✔️ Dosage & Administration of Gluretor 0.5

• For newly diagnosed patients or those with HbA1c <8%:
  • Start with 0.5 mg before each meal.
• For patients previously on glucose-lowering drugs with HbA1c >8%:
  • Initiate with 1 or 2 mg before each meal.
• Administration Guidelines:
  • Gluretor should be taken immediately or up to 30 minutes before meals.
  • The dosage can be adjusted based on response at 1- to 2-week intervals.
  • The maximum single dose is 4 mg, and the daily dose should not exceed 16 mg.

Note: This medication should be taken as per a physician’s recommendation.

✔️ Drug Interactions

• Drugs that increase Gluretor levels (risk of prolonged action):
  • Inhibitors of cytochrome P450 enzymes (e.g., azole antifungals, macrolides) can reduce Gluretor clearance, leading to longer-lasting effects.
• Drugs that accelerate Gluretor metabolism (shortening its effect):
  • P450 enzyme inducers (e.g., Rifampin, Phenobarbital, Carbamazepine, Troglitazone) speed up its breakdown, potentially reducing effectiveness.
• Drugs with no significant effect on Gluretor:
  • Cimetidine does not impact its absorption or clearance.
  • Gluretor does not significantly interact with Digoxin, Theophylline, or Warfarin.
• Highly protein-bound drugs (e.g., NSAIDs):
  • These may increase unbound Gluretor levels, enhancing its glucose-lowering effect and potentially increasing hypoglycemia risk.
• Medications that may increase the risk of hypoglycemia:
  • Salicylates, sulfonamides, chloramphenicol, coumarins, probenecid, MAO inhibitors, and adrenergic blockers can potentiate Gluretor’s hypoglycemic effect, increasing the risk of dangerously low blood sugar levels.

✔️ Overdose Effects

• High doses (up to 80 mg) have been tolerated with minimal adverse effects beyond blood sugar reduction.
• Hypoglycemia is unlikely if food is consumed in high doses.
• Severe hypoglycemic episodes (coma, seizures, neurological impairment) are rare but require immediate medical intervention.

✔️ Pregnancy & Lactation

• Pregnancy:
  • Safety in pregnant women has not been established. It should only be used if the benefits outweigh the risks.
• Lactation:
  • It is unknown whether Repaglinide is excreted in human milk.
  • Due to the potential for adverse effects in infants, a decision must be made whether to discontinue breastfeeding or discontinue the drug, depending on its importance to the mother.

✔️ Gluretor (Repaglinide) should not be used in patients with:

• Diabetic ketoacidosis, with or without coma.
• Type 1 diabetes mellitus (as it requires insulin therapy).
• Known hypersensitivity to Repaglinide or its inactive components.

✔️ Precautions & Warnings

• Substituting Insulin During Illness or Surgery:
  • In cases of severe illness, trauma, infection, or surgery, insulin may be required instead of Gluretor.
• Hypoglycemia Risk:
  • Like all oral glucose-lowering agents, Gluretor can cause hypoglycemia.
  • To minimize this risk, it should be taken with meals.
• Use in Patients with Hepatic Impairment:
  • Since Repaglinide is metabolized in the liver, caution is advised in patients with liver dysfunction.

✔️ Storage Conditions

• Store at a temperature below 30°C, away from light and moisture.
• Keep out of reach of children.